Relationship Between Fibril Length and Tissue Ingrowth in the Healing of Expanded Polytetrafluoroethylene Grafts

Hazama, Kazuaki; Miura, Hiroto; Shimada, Toshifumi; Okuda, Yasuhiro; Murashita, Takashi; Nishibe, Toshiya

doi:10.1007/s00595-004-2774-9

Cited by 12 publications

(10 citation statements)

References 18 publications

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“…The ePTFE graft has a characteristic node-fibril lattice structure with an average pore size (inter-nodal distance) of 30 μm for a standard graft, which is believed to affect the rate of development of the neointima and endothelialization, which protect against infection [12]. The portion of the graft that migrated into the intestine allows formation of biofilm by the intestinal microbes, and this has been assessed by quantitative cultures and microscopy techniques [13].…”

Section: Discussionmentioning

confidence: 99%

Assessing the Safety of Expanded Polytetrafluoroethylene Synthetic Grafts in Living Donor Liver Transplantation: Graft Migration Into Hollow Viscous Organs – Diagnosis and Treatment Options

et al. 2017

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BackgroundOur recent studies have highlighted the importance and safety of backtable venoplasty for middle hepatic vein (MHV) and inferior right hepatic veins (IRHV) reconstruction using expanded polytetrafluoroethylene (ePTFE) vascular grafts. In this study, we aim to analyze the complications associated with ePTFE graft use and discuss the management of the rare, but, potentially life threatening complications directly related to ePTFE conduits.Material/MethodsFrom January 2012 to October 2015 a total of 397 patients underwent living donor liver transplantation (LDLT). The ePTFE vascular grafts were used during the backtable venoplasty for outflow reconstruction in 262 of the liver allografts. Recipients who developed ePTFE-related complications were analyzed.ResultsePTFE-related complications developed in 1.52% (4/262) of the patients. One patient (0.38%) developed complete thrombosis with sepsis at 24 months post-transplantation and died due to multiorgan failure. Three patients (1.1%) developed graft migration into the second portion of the duodenum, without overt peritonitis. Surgical exploration and ePTFE graft removal was done in all the patients. One patient died due to overwhelming sepsis.ConclusionsePTFE graft migration into the duodenum causing perforation is a new set of complications that has been recently described in LDLT and can be treated effectively by surgical removal of the infected vascular graft and duodenal perforation closure. Despite of such complications, in our experience, ePTFE use in LDLT continues to have wide safety margin, with a complication rate of only 1.52%.

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Section: Discussionmentioning

confidence: 99%

Assessing the Safety of Expanded Polytetrafluoroethylene Synthetic Grafts in Living Donor Liver Transplantation: Graft Migration Into Hollow Viscous Organs – Diagnosis and Treatment Options

et al. 2017

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“…15 We used 60-µm ePTFE vascular grafts because several laboratories, including ours, found that endothelial healing was better in 60-µm ePTFE vascular grafts than in 30-or 90-µm vascular grafts. 5,9 Transmural tissue ingrowth was most evident in 60-µm grafts, then in 90-µm grafts, and least in 30-µm grafts. 9 Covalent bonding of fibronectin was prepared as described previously.…”

Section: Graft Characteristics and Preparationsmentioning

confidence: 96%

“…5,9 Transmural tissue ingrowth was most evident in 60-µm grafts, then in 90-µm grafts, and least in 30-µm grafts. 9 Covalent bonding of fibronectin was prepared as described previously. 10 The grafts were treated with a mixed solution of methyl lithium and hexamethyl phosphoric amide (Aldrich Chemicals, Milwaukee, WI, USA) in argon gas at 0°C for 30 min, leaving the surface defluorinized.…”

Section: Graft Characteristics and Preparationsmentioning

confidence: 96%

“…In the 1990s, several investigators, including members of our laboratory, demonstrated that the healing properties of ePTFE vascular grafts could be improved by making the grafts porous. [3][4][5][6][7][8][9] Recent reports have described several techniques using biological materials to stimulate transmural tissue ingrowth. [10][11][12][13] Our preliminary results on short-term canine and porcine models demonstrated that covalent bonding of fibronectin enhanced the healing of smallcaliber (4 mm), long-fibril (60 µm) ePTFE vascular grafts.…”

Section: Introductionmentioning

confidence: 99%

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Improved Healing of Small-Caliber, Long-Fibril Expanded Polytetrafluoroethylene Vascular Grafts by Covalent Bonding of Fibronectin

et al. 2004

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“…3 Pore size can affect the rate of development of the neointima and endothelialization, which is believed to protect against infection. 4 Graft infections can originate either from bacterial colonization of the external surface or from endovascular seeding of the internal surface, but it is unknown if bacteria can translocate from one surface of these porous grafts to another. This question merits assessment because it is critical for understanding the pathogenesis of graft infections.…”

Section: Introductionmentioning

confidence: 99%

Bacterial translocation across ePTFE vascular graft surfaces

Narasimhan

Aslam

Lin

et al. 2010

Journal of Infection

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Summary Objectives Vascular graft infections arise from bacterial colonization of either the external or internal graft surfaces. We assessed whether methicillin-resistant Staphylococcus aureus (MRSA) and Escherichia coli could translocate through pores of ePTFE grafts. Methods To assess translocation from the internal to the external surface, we placed 105 cfu of bacterial suspension inside ePTFE graft segments and suspended them in sterile broth for 72 h. To assess translocation from the external to the internal surface, we placed sterile broth inside ePTFE segments, and incubated them for 72 h in a bacterial suspension (105 cfu/mL). At 72 h, in addition to culturing the sterile broth and bacterial suspensions, the external and internal surfaces were first qualitatively cultured separately and then quantitatively cultured by sonication. Results At 72 h, the sterile broth remained sterile. The bacterial suspensions yielded 107–109 cfu/mL. Graft cultures indicated that colonization of one surface with either organism did not result in bacterial translocation to the other surface. Quantitative bacterial counts of the external vs. internal surfaces were significantly different (p < 0.01). Conclusions MRSA and E. coli do not translocate across ePTFE graft surfaces. These in-vitro findings help elucidate the pathogenesis of graft infections and prompt conduction of validation studies in-vivo.

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Relationship Between Fibril Length and Tissue Ingrowth in the Healing of Expanded Polytetrafluoroethylene Grafts

Abstract: Better endothelial healing of ePTFE vascular grafts is correlated with more cellular and capillary ingrowth, but more cellular and capillary ingrowth is not correlated with longer fibril length or higher air porosity.

Cited by 12 publications

References 18 publications

Assessing the Safety of Expanded Polytetrafluoroethylene Synthetic Grafts in Living Donor Liver Transplantation: Graft Migration Into Hollow Viscous Organs – Diagnosis and Treatment Options

Assessing the Safety of Expanded Polytetrafluoroethylene Synthetic Grafts in Living Donor Liver Transplantation: Graft Migration Into Hollow Viscous Organs – Diagnosis and Treatment Options

Improved Healing of Small-Caliber, Long-Fibril Expanded Polytetrafluoroethylene Vascular Grafts by Covalent Bonding of Fibronectin

Bacterial translocation across ePTFE vascular graft surfaces

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